Authorizations Note Templates

Authorizations Note Templates

Comments


Scenario

Note Type

Note Template

Repair using CHS Parts

Private

AUTHORIZATIONS NOTE:

Caller Name & Company – Bob with Joe’s Appliance

Age/Condition of Unit – 10 years old, good condition

Failed Equipment – Control board shorted

Reason for Failure – Normal wear and tear

Action Taken – Sent parts to research for possible repair

Next Steps – SP contacted once parts are spec’d

Additional Information – Attempted to self-service, unable to locate parts

Public w/ Email

SERVICE JOB APPROVED:

Service Call: $75.00

Parts/Equipment:

Total Labor $150.00

Total Tax: $13.00

Additional Charges: $0

Total Payable from CHS: $238

Repair using Marcone Parts

Private

AUTHORIZATIONS NOTE:

Caller Name & Company – Bob with Joe’s Appliance

Age/Condition of Unit – 10 years old, good condition

Failed Equipment – Control board shorted, Bake element shorted

Reason for Failure – Normal wear and tear

Action Taken – Self- served parts and ordered using Marcone

Next Steps – once SP has received parts, they will contact customer to schedule repair

Additional Information –

Public w/ Email

SERVICE JOB APPROVED:

Service Call: $75.00

Parts/Equipment:

Total Labor: $15.00

Total Tax: $13.00

Additional Charges: $0

Total Payable from CHS: $103.00

Repair/Replace using SP Parts

Private

AUTHORIZATIONS NOTE:

Caller Name & Company – Bob with Joe’s Appliance

Age/Condition of Unit – 10 years old, good condition

Failed Equipment – Control board shorted

Reason for Failure – Normal wear and tear

Action Taken – Approved repair using S/P parts, Created exception to have customer advised of non-covered charges

Next Steps – SP will complete repairs when they get part

Additional Information – Bob says he can complete repair today

Non-Covered Charges - <list each non-covered charge and amount, if applicable>

Public w/ Email

SERVICE JOB APPROVED:

Service Call: $75.00

Parts/Equipment: $170.00

Total Labor: $150.00

Total Tax: $13.00

Additional Charges: $0

Total Non-Covered Charges: $500

Total Payable from CHS: $308.00

Replace using CHS Equipment

Private

AUTHORIZATIONS NOTE:

Caller Name & Company – Bob with Joe’s Appliance

Age/Condition of Unit – 10 years old, poor condition

Failed Equipment – Internal wire shorted

Reason for Failure – Normal wear and tear

Action Taken – Sent to research for possible replacement, Created exception to have customer advised of non-covered charges

Next Steps – Customer will be contacted once replacement is selected

Additional Information – Unit is unrepairable

Non-Covered Charges - <list each non-covered charge and amount, if applicable>

Public w/

Email

SERVICE JOB APPROVED:

Service Call: $75.00

Total Tax: $12.00

Additional Charges: $0

Total Non-Covered Charges: $0

Total Payable from CHS: $87.00

Not Addressed

Private

AUTHORIZATIONS NOTE:

Caller Name & Company – Bob with Joe’s Appliance

Age/Condition of Unit – 10 years old, poor condition

Failed Equipment – Glass top broken

Reason for Failure – No mechanical failure

Action Taken – Contacted customer to advise of job not being addressed

Next Steps – SP will reach out to customer to see if they would like to move forward with repair at their cost

Additional Information – Not Addressed: glass top is structural, not addressed per section iii, 1. Kitchen and Laundry Appliances: Structural Components (only copy section of paragraph related to denial, not the entire paragraph)

Public w/ Email

SERVICE JOB NOT ADDRESSED / CLAIM APPROVAL:

Service Call: $75.00

Parts/Equipment: Not addressed

Total Labor: Not addressed

Total Tax: Not addressed

Total Payable from CHS: $75.00

General Questions & Inquiries

Private

AUTHORIZATIONS NOTE:

Caller Name & Company – Bob with Joe’s Appliance

Purpose of Call – Checking coverage for dishwasher pump

Action Taken – Advised pump is covered under contract. Advised of a mechanical failure due to normal wear and tear per contract

Next Steps – SP to call back with service report

Additional Information – Bob says he can complete repair today

Public w/ Email

SERVICE JOB PENDING SERVICE REPORT:

Service Call: $75.00

Verbal Approval for Additional Diagnosis, Diagnostic Tests, & Travel

Public w/ Email

APPROVED DIAGNOSIS/TRAVEL ONLY:

Additional Diagnosis: $50.00

Electronic Leak Search: $75.00

Travel Fee: $35.00

Service Explanation


Job Summary Template

<Final Status>, <Deductible Status>, <SP Comments>

Example:

Approved Repair, Deductible Paid, SP will complete repairs today

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